The results of a new survey of 300 gay men were recently released by Bespoke Surgical, a self-described “elite anal surgery practice” focused on sexual wellness. The company focuses on preventative screenings, anal rejuvenation including botox and bleaching as well as anal restoration services like skin tags, anal warts, hemorrhoids, abscesses, fistulas, and fissures.

So it’d make sense they would want to know more about how gay men feel about anal sex and their preparation for it.

One question posed by the company focused on condom usage. They found that 37% of their respondents always use a condom during anal sex, 21% occasionally do, and 16% never use a condom.

The company found that among its respondents hygiene was a major concern before and after anal sex.

78% of those polled said they think about cleanliness always or most of the time during anal sex, while just 9% never think about it. And clean-up was important to 61%, who said they would feel more comfortable if they used some sort of anal cleanser afterwards.

As for the frequency of anal sex:

39% – a couple times a week.24% – a couple times a month.13% – daily

Writes Bespoke: “Put another way, 5 in 6 gay men have anal sex at least a few times each year. Only 1 in 6 partake less than once each year. This information has implications: it confirms that the topic of anal sex preparation is something that impacts many people. Plus, if it’s something that most people don’t do properly, it’s a issue about which people need to be educated.”

As far as preparation goes, those polled by Bespoke on their use of a douche before sex replied with these answers:

They add: “Interestingly, gay men who have anal sex daily are 1.3 – 2.1 times more likely to always use an anal cleansing product, compared to those who do it less often. We found that, generally speaking, the less frequently someone has anal sex, the more likely they are to never use an anal cleansing product.”

Bespoke also found that, among its respondents, 25% used a water-based enema to prepare for sex, 20% used a saline enema, and 18% used a shower adapter.

But should you even be douching at all? Not according to some experts.

Dr. Evan Goldstein, who founded Bespoke, told VICE that douching too often can lead to other health issues: “If you’re doing it every day, there are a lot of issues with enemas. You can lengthen your colon, and that can lead to constipation later in life. That’s what’s so dangerous about it. It’s not threatening, but it’s a real pain in the ass, so to speak, it can make you uncomfortable and miserable.”

Goldstein said that there’s little chance you’re gonna run into anything up there anyway: “Imagine if you line up ten guys, and you’re going to top them all. Even if they haven’t prepared, nine out of ten would be completely stool-free.”

And Dr. Stephen Goldstone, an assistant clinical professor of surgery at Mount Sinai Hospital and a specialist in anorectal disease and gay men’s health, agreed, explaining that feces stay in an upper part of the colon called the sigmoid colon until you’re ready to take a dump, so encountering them during sex isn’t going to occur most of the time.

Also, don’t use Fleet or other based saline enemas because the chemicals in them are super harsh on your rectum, causing irritation, along with dryness and mucus issues that can lead to bleeding and make transmission of STDs more likely.

If you want to make a change, try adding more dietary fiber to your diet, and consider just washing your anal area before sex. If you absolutely must douche, do it with plain water, and not too much of it.

For some further tips, check out the clips on the top and the bottom of this post.

Bespoke’s survey also asked about sex toys, and anal damage. They reported: “We found that 41% of gay men have experienced tearing or other damage from anal sex. Finally, the data tells us that 45% of gay men don’t use a sex toy for anal sex at all, while 41% use one at least to prepare. 55% use one for pleasure, to prepare, or both. It’s possible that those who use a toy to prepare may be doing so to avoid tearing or other damage.”

Bespoke’s survey found that 39% of men said they were tops, 29% identified as bottoms, and 33% described themselves as versatile.

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